Lake County

Public Health Assessment and Wellness

The Inter-departmental Task Force on Childhood Obesity

State: IL
Type: Model Practice
Year: 2011

ABSTRACT:

"Early in 2006 the Chicago Department of Public Health (CDPH) released its strategic plan for the period 2006-2011. The plan identified seven strategic priorities. Strategic priority number one was to prevent chronic disease and promote health for all Chicagoans. In March of that same year, the Commissioner of Health convened a meeting with other city department heads to confront the critical and multi-factorial challenge of childhood obesity. In addition to the Commissioner, the Superintendent of the Chicago Public Schools (CPS), the Superintendent of the Chicago Park District and the Commissioner of, what was then the Department of Children and Youth Services as well as the Executive Director of the Consortium to Lower Obesity in Chicago Children (CLOCC) attended this inaugural meeting.

While on the surface this convening might seem like a relatively easy feat, one must bear in mind that CPS is the third largest school district in the nation with a student population of over 400,000; the Chicago Park District oversees more than 7600 acres of parkland and maintains 570 parks; and the Department of Children and Youth Services was responsible for the coordination and provision of services to the city’s youth and children from birth through adolescence. The outcome of this meeting was the establishment of the city’s Inter-Departmental Task Force on Childhood Obesity (IDTF). Its mission is to demonstrate that city government has a significant role in confronting childhood obesity and while its overarching objective is the prevention of childhood obesity; its primary target population is the preschool-age population.

IDTF employs a social ecological model which considers the complex interplay between the individual, their relationships, the broader community, and societal factors in the development of illness and disease and utilizes a three-tiered approach to obesity prevention. IDTF Three-Tiered Approach 1) A focus on primary prevention activities with the potential to reach approximately 750,000 Chicago-area children 2) The development of new and/or improved inter-departmental programs and partnerships to potentially impact 261,000 of Chicago’s preschool-aged children 3) The establishment of a strategically located Wellness Campus, which will serve as the cornerstone of the IDTF approach The Wellness Campus is ‘virtual’ as its intended anchor is a ‘Wellness Center’, which could be a Health Department Clinic, a Chicago Public School, or a Park District Facility, that serves as the hub for all Wellness Campus activities. As such it would be the focal point for better alignment of government resources, programming and services offered by and through IDTF members. To date, funding has been secured for six Wellness Centers and two have already opened. It was a direct result of the work of CLOCC that obesity was identified as an important concern, and further, that an integrated, strategic and systematic approach from local government was an important part of any solution moving forward. Founded in 2002, CLOCC is an evidenced-based effort to coalesce organizations and individuals from throughout Chicago together with a common goal of protecting Chicago children from the effects of the obesity epidemic."

ORGANIZATION:

Chicago Department of Public Health

TITLE:

The Inter-departmental Task Force on Childhood Obesity

"Early in 2006 the Chicago Department of Public Health (CDPH) released its strategic plan for the period 2006-2011. The plan identified seven strategic priorities. Strategic priority number one was to prevent chronic disease and promote health for all Chicagoans. In March of that same year, the Commissioner of Health convened a meeting with other city department heads to confront the critical and multi-factorial challenge of childhood obesity. In addition to the Commissioner, the Superintendent of the Chicago Public Schools (CPS), the Superintendent of the Chicago Park District and the Commissioner of, what was then the Department of Children and Youth Services as well as the Executive Director of the Consortium to Lower Obesity in Chicago Children (CLOCC) attended this inaugural meeting.
While on the surface this convening might seem like a relatively easy feat, one must bear in mind that CPS is the third largest school district in the nation with a student population of over 400,000; the Chicago Park District oversees more than 7600 acres of parkland and maintains 570 parks; and the Department of Children and Youth Services was responsible for the coordination and provision of services to the city’s youth and children from birth through adolescence. The outcome of this meeting was the establishment of the city’s Inter-Departmental Task Force on Childhood Obesity (IDTF). Its mission is to demonstrate that city government has a significant role in confronting childhood obesity and while its overarching objective is the prevention of childhood obesity; its primary target population is the preschool-age population.
IDTF employs a social ecological model which considers the complex interplay between the individual, their relationships, the broader community, and societal factors in the development of illness and disease and utilizes a three-tiered approach to obesity prevention. IDTF Three-Tiered Approach 1) A focus on primary prevention activities with the potential to reach approximately 750,000 Chicago-area children 2) The development of new and/or improved inter-departmental programs and partnerships to potentially impact 261,000 of Chicago’s preschool-aged children 3) The establishment of a strategically located Wellness Campus, which will serve as the cornerstone of the IDTF approach The Wellness Campus is ‘virtual’ as its intended anchor is a ‘Wellness Center’, which could be a Health Department Clinic, a Chicago Public School, or a Park District Facility, that serves as the hub for all Wellness Campus activities. As such it would be the focal point for better alignment of government resources, programming and services offered by and through IDTF members. To date, funding has been secured for six Wellness Centers and two have already opened. It was a direct result of the work of CLOCC that obesity was identified as an important concern, and further, that an integrated, strategic and systematic approach from local government was an important part of any solution moving forward. Founded in 2002, CLOCC is an evidenced-based effort to coalesce organizations and individuals from throughout Chicago together with a common goal of protecting Chicago children from the effects of the obesity epidemic."

A 2009 report from the Institute of Medicine entitled, Local Government Actions to Prevent Childhood Obesity in the United States found that 16.3 percent of children and adolescents between the ages of two and 19 are obese. Even more alarming was the fact that in a little more than three decades, obesity prevalence among children two to five years old increased from 5 percent to 12.4 percent; among children six to 11, it increased from 6.5 percent to 17 percent; and among adolescents 12 to 19 years old, it increased from 5 percent to 17.6 percent. The report went on to state that the “prevalence of obesity is so high that it may reduce the life expectancy of today’s generation of children and diminish the overall quality of their lives. Obese children and adolescents are more likely than their lower-weight counterparts to develop hypertension, high cholesterol, and type-2 diabetes when they are young, and they are more likely to be obese as adults”.
Illinois has the 4th highest rate of childhood obesity among all states and the 2003 CLOCC annual report found that in Chicago the percentage of obese children entering Kindergarten was two times the national average. While nationally, obesity prevalence for children 2-5 years old was about 10 percent, in Chicago obesity prevalence among children 3-7 years old was 22 percent. Across the US, the obesity prevalence for children 6-11 years old was 19.6 percent. In Chicago, the obesity prevalence among children 10-13 years old was 28 percent. Further a 2004 report from the Sinai Urban Health Institute found that the prevalence of obesity among children living in communities of color is significantly higher compared that to Chicago children as a whole and US children nationally.

Agency Community RolesCDPH was the original convener of the IDTF and continues to serve as the group’s chair. The idea for the IDTF emanated from CDPH’s participation on CLOCC. In the Spring of 2006, CDPH, in collaboration with what was at the time the city’s Department of Children and Youth Services (DCYS), worked with CLOCC to organize and convene the first IDTF meeting. It had become obvious during meetings of the CLOCC Governmental Policies and Programs Working Group (which was co chaired by the CDPH Assistant Commissioner for Chronic Disease and the First Deputy Commissioner of DCYS) that there was a genuine need for more involvement from government agencies, and that without more buy-in and participation from a myriad of public agencies, it would be difficult for CLOCC to move its policy agenda forward. The first meeting consisted of the leadership of CDPH, DCYS, the Chicago Public Schools, the Chicago Park District as well as the Executive Director of CLOCC. IDTF was established to address childhood obesity by bringing together City resources and getting disparate city agencies to work in a collective manner thereby fostering a high-level of coordination, the strategic provision of city services, and the advancement of evidence-based practices and policies to improve nutrition and physical activity.
The Task Force has now expanded to include eleven City agencies, each with programs, policies and/or services that promote and contribute to IDTF’s approach to obesity prevention. IDTF’s current membership consists of the following city agencies: CDPH (lead agency), Chicago Department of Environment, Chicago Department of Family and Support Services (Children Services Division, Youth Services Division, and Senior Services Area Agency on Aging), Chicago Department of Transportation, Chicago Department of Zoning and Land Use Planning, Chicago Housing Authority, Chicago Park District, Chicago Police Department, Chicago Public Schools, Chicago Transit Authority, and the Mayor’s Office for People with Disabilities.
Costs and ExpendituresEarly in 2006 the Chicago Department of Public Health (CDPH) released its strategic plan for the period 2006-2011. The plan identified seven strategic priorities. Strategic priority number one was to prevent chronic disease and promote health for all Chicagoans. In March of that same year, the Commissioner of Health convened a meeting with other city department heads to confront the critical and multi-factorial challenge of childhood obesity. In addition to the Commissioner, the Superintendent of the Chicago Public Schools (CPS), the Superintendent of the Chicago Park District and the Commissioner of, what was then the Department of Children and Youth Services as well as the Executive Director of the Consortium to Lower Obesity in Chicago Children (CLOCC) attended this inaugural meeting. While on the surface this convening might seem like a relatively easy feat, one must bear in mind that CPS is the third largest school district in the nation with a student population of over 400,000; the Chicago Park District oversees more than 7600 acres of parkland and maintains 570 parks; and the Department of Children and Youth Services was responsible for the coordination and provision of services to the city’s youth and children from birth through adolescence.
The outcome of this meeting was the establishment of the city’s Inter-Departmental Task Force on Childhood Obesity (IDTF). Its mission is to demonstrate that city government has a significant role in confronting childhood obesity and while its overarching objective is the prevention of childhood obesity; its primary target population is the preschool-age population. IDTF employs a social ecological model which considers the complex interplay between the individual, their relationships, the broader community, and societal factors in the development of illness and disease and utilizes a three-tiered approach to obesity prevention.
IDTF Three-Tiered Approach 1) A focus on primary prevention activities with the potential to reach approximately 750,000 Chicago-area children 2) The development of new and/or improved inter-departmental programs and partnerships to potentially impact 261,000 of Chicago’s preschool-aged children 3) The establishment of a strategically located Wellness Campus, which will serve as the cornerstone of the IDTF approach The Wellness Campus is ‘virtual’ as its intended anchor is a ‘Wellness Center’, which could be a Health Department Clinic, a Chicago Public School, or a Park District Facility, that serves as the hub for all Wellness Campus activities. As such it would be the focal point for better alignment of government resources, programming and services offered by and through IDTF members. Founded in 2002, CLOCC is an evidenced-based effort to coalesce organizations and individuals from throughout Chicago together with a common goal of protecting Chicago children from the effects of the obesity epidemic.
ImplementationAs was stated earlier the mission of Chicago’s Inter-Departmental Task Force on Childhood Obesity (IDTF) is to demonstrate that City government plays a leadership role in addressing childhood obesity. IDTF leadership from the Chicago Department of Public Health in collaboration with the Consortium to Lower Obesity in Chicago Children initiated a strategic approach to accomplish the IDTF mission.
Specific tasks that were undertaken to achieve its mission were:
• Identify and prioritize existing programs and policies that determine what Chicago’s families eat and drink, and how they get their daily physical activity.
• Integrate and Coordinate these programs and policies with each other for the maximum possible benefit to Chicago children and families.
• Emphasize and utilize evidence-informed interventions to promote the daily consumption of fresh produce, dairy or non-dairy substitute and water, limited screen time, and physical activity.
• Support staff from each participating department in the work of the Task Force.
• Advocate for priority policies and programs, and the resources required to develop, test, and administer them.
While much of the work of IDTF is ongoing and the context in which this work is done is often fluid, identifying and prioritizing Chicago’s existing access to healthy food and physical activity programs and policies has helped to focus the work of IDTF moving forward. The initial baseline assessment was completed toward the end of first year of IDTF’s existence and is updated routinely. IDTF integration and coordination of programs is ongoing. For example, the city’s Safe Routes to Schools Program, housed in the Department of Transportation, has worked with the Chicago Transit Authority and the Department of Planning to map area resources around two of the aforementioned Chicago Park District Wellness Centers and identify the safest and most efficient points of access. There has always been an emphasis on utilizing evidenced-based approaches to accomplish IDTF’s mission.
However, this took on even greater significance as IDTF played an integral role in framing the city’s successful HHS Communities Putting Prevention to Work (CPPW) application submitted by CLOCC in partnership with the Chicago Department of Public Health, through which we were awarded $5.8 million. These funds will be used to support initiatives that aim to improve access to healthy food and safe opportunities for physical activity at the neighborhood level through policy, systems and environmental change strategies. We believe it is because the IDTF already existed that the City of Chicago was so well poised to submit its CPPW grant application and launch into implementation once the grant was awarded.

IDTF is currently working with a local university to conduct a formal evaluation of its efforts. In lieu of a formal evaluation there are certainly other indicators that IDT can use to gauge its value as well as its successes. For example, IDTF initially started meeting as needed. However, in early 2009, after a meeting with IDTF leadership, it was agreed that in order to move forward on its mission, the membership of IDTF needed to expand from its four original agencies to other city agencies and that an annual set of objectives needed to be developed. Since 2009, IDTF has grown from 4 to 11 city agencies, has established a set of annual objectives, has created committees to support the work of each of these objectives, and meets monthly.
Other examples include:
• Passage of resolution by the Chicago Board of Health for changes in the licensed day care standards pertaining to physical activity, nutrition, and screen time o These changes allowed CLOCC to apply for and receive a $150,000 grant from RWJF to evaluate the impact of these changes in the childcare settings
• As a result of a grant from Abbott Laboratories, the Chicago Park District opened two Wellness Centers. These Wellness Centers now serve as the anchor sites for the City’s first two IDTF Wellness Campus initiatives o An evaluation by CLOCC found a statistically significant difference in vigorous physical activity levels among children in Wellness Center programs when compared to traditional Park District programming o The Chicago Park District has received funding from Blue Cross/Blue Shield of Illinois to fund 4 additional Wellness Centers
• IDTF’s partnership with the Logan Square Neighborhood Association helped in securing local funding from the Robert Wood Johnson Foundation for Healthy Kids, Healthy Communities. Chicago has been identified as one of the nine leading communities among a total of 50 funded communities.

Illinois has the 4th highest rate of childhood obesity among all states and a 2003 CLOCC report found that in Chicago the percentage of obese children entering Kindergarten was two times the national average. There are no quick fixes for the childhood obesity epidemic in this country and the city of Chicago is prepared and poised to do whatever it takes to meet the challenge. Established in 2006, IDTF has withstood major changes in leadership at the highest levels. The Superintendent of Schools at the time has gone on to become U.S. Secretary of Education. There have been two other Superintendents in that time and there has never been a lapse in involvement and support for the work of IDTF from the Chicago Public Schools, one of the largest systems in the nation. With the Chicago Department of Public Health as the lead, the city’s Chicago Department of Environment, Chicago Department of Family and Support Services (Children Services Division, Youth Services Division, and Senior Services Area Agency on Aging), Chicago Department of Transportation, Chicago Department of Zoning and Land Use Planning, Chicago Housing Authority, Chicago Park District, Chicago Police Department, Chicago Public Schools, Chicago Transit Authority, Mayor’s Office for People with Disabilities and the Chicago Public library all view the mission and work of IDTF as a vital part of its own unique mission and purpose.
IDTF could only have existed to this point through the consistent and effective leveraging of existing resources and commitment of its member agencies. The cost of IDTF representative participation from each member agencies is absorbed by that agency. Meeting space is provided at no cost by the host agency for the meeting and the Consortium to Lower Obesity in Chicago Children provides administrative support at no cost to the city. The city’s successful application for the HHS Communities Putting Prevention to Work program in support of its obesity prevention efforts is providing a real-time opportunity for broader collaboration and engagement of IDTF partners. We are looking at this cooperative agreement as a time to build capacity and infrastructure to assure that the work of IDTF will continue well beyond the 2-year grant period. Each IDTF member agency has been tasked with the responsibility for assuring that its work related to the IDTF is incorporated into their agency’s strategic plan and revisited on an annual basis. We also are developing a three-year IDTF policy agenda to align the legislative pursuits of the various IDTF members at the local, state and federal levels.
Additionally, IDTF convenes an annual Leadership meeting, which brings together the chief executive of each member agency, to discuss, review, endorse and act upon the IDTF strategies that are presented. A formal evaluation of the work of IDTF is currently underway and we fully expect the results to provide evidence of the value of IDTF and its ability to be replicated. Further, CDPH is poised to unveil a Public Health Agenda, which will serve as a blueprint for the Department for the next 5-10 years. The IDTF workplan, as well as its goals and objectives, is well-integrated into the Agenda, as Obesity is one of the Agenda’s priority areas.